The proposed program is designed to evaluate and document the specific anatomic deformities which characterize each of the various syndromes in craniofacial anomalies, and, though carefully controlled longitudinal growth studies in patients admitted to the study at different age levels, to determine craniofacial growth patterns in unoperated patients and to detemine the optimal timing and temporal sequence of reconstructive surgical procedures in craniofacial anomalies. This program includes longitudinal studies of specific changes in craniofacial morphology and function resulting from the institution of combined surgical-orthodontic-prosthodontic reconstructive therapy at different age levels in each of the major categories of craniofacial anomalies, and detailed studies of the effects of early surgery on craniofacial growth and morphology. Attention will be focused on the early surgical manipulation of craniofacial sutures in patients with craniofacial dysostosis. New areas of study include: 1) olfactory and taste evaluation in all patients, and study of the effects of craniofacial surgery on these modalities; (2) usefulness of soft tissue contouring of the face as an adjunct to pre-surgical planning; 3) assessment of speech before and after surgery; (4) evaluation of neurological deformities associated with craniofacial malformations; 5) study of extraocular muscle and retinal function in patients with craniofacial malformations; 6) radiographic and pathologic evaluation of temporal bone status in craniofacial malformations; 7) psychosocial and psychometric evaluation of all patients. Proposed genetic studies include complete family history, pedigree analysis and examination of the patients with the view of detecting consistent differences in the phenotype of patients with similar syndromes. Immunogenetic studies will document the incidence and segregation of the products of the HLA complex in families afflicted with craniofacial developmental anomalies and will compare the results with similar data obtained in normal family units of similar background.